The Impact of COPD on the Heart
Blues Perspectives
| 4 min read
More than 15 million Americans have chronic obstructive pulmonary disease (COPD), according to the Centers for Disease Control and Prevention (CDC). More Americans likely have it and do not yet know. COPD is one of the 10 leading causes of death in the United States. COPD causes an increase in resistance to airflow in the airways causing an increase in work of breathing. This results in shortness of breath at rest and even more on excretion. Loss of pulmonary blood vessels and narrowing of blood vessels due to low oxygen levels results in Pulmonary hypertension, leading to an increased risk of developing heart disease and cardiovascular conditions.
Are COPD and cardiovascular issues related?
Cardiovascular involvement and complications in COPD additionally increase causes of death in patients with COPD, according to a 2019 study. Individuals with COPD are more likely to have or develop heart disease. Those with COPD have higher rates of coronary artery calcium (CAC) than the general populace, according to the American Heart Association. Individuals with COPD and high levels of CAC buildup are three times more likely to die from any cause than those without CAC. Pulmonary hypertension which occurs in COPD leads to Right sided cardiac failure increasing the morbidity and mortality from COPD.
Having both COPD and heart disease is associated with functional limitations of the heart and a higher risk of heart failure. COPD and heart conditions are linked, often coexisting and exacerbating each other, because COPD’s effects on the lungs and bronchi can cause the heart to receive less oxygen and undergo more stress.
How does COPD affect the heart?
COPD negatively affects the heart in a few different ways. While left-sided heart failure and COPD often coexist, they do not seem to have a causal connection. However, severe COPD can cause the development of right-sided heart failure due to Pulmonary Hypertension resulting from destruction of blood vessels and low oxygen levels. Low oxygen levels resulting from severe COPD can cause increased blood pressure in the arteries of the lungs. This increased blood pressure can put excess strain on the right ventricle of the heart and cause the heart muscles to weaken, potentially leading to right-sided heart failure. Specifically, heart conditions commonly caused by COPD include:
- ischemic coronary disease
- right-sided heart failure
- right ventricular dysfunction
- pulmonary hypertension
- arrhythmia and dysrhythmia
Rates of coronary heart disease are higher among patients with COPD, although COPD does not always result in increased CAC, the cause of coronary heart disease. In fact, different markers of COPD such as emphysema scores, reduced lung function or exacerbation of COPD symptoms do not predict whether or not an individual has coronary heart disease or coronary stenosis. This relationship may stem from the fact that COPD and heart disease have some of the same risk factors, such as aging, smoking and genetic factors. However, one in five people with COPD have never smoked and still have an increased risk of developing heart disease.
What are symptoms of cardiovascular issues associated with COPD?
Many symptoms of heart disease and COPD are similar; and many people with one condition do not realize they also have the other. They may also assume some symptoms, like shortness of breath or trouble breathing when exerting themselves, are simply signs of aging. The American Heart Association suggests that patients with COPD getting lung imaging receive heart imaging to check for commonly co-existing heart conditions. Sometimes heart conditions may be noticeable through lung scans. Similar symptoms of both COPD and cardiovascular issues include:
- trouble breathing or shortness of breath
- Shortness of breath (Dyspnea) on minimal excretion
- Low oxygen saturation
- chest pains and tightness
- ongoing cough or wheezing
- loss of appetite
- swelling of the lower extremities
- cardiac arrythmias
What can be done to reduce the risk of COPD and heart disease?
The best way to reduce the risk of both COPD and heart disease is to make lifestyle changes to address risk factors.
- Stop smoking, as smoking is the number one risk factor for both heart disease and COPD.
- Eat a heart-healthy diet with limited amounts of red meat, processed meats, dairy products and ultra-processed foods that can reduce the risk of heart disease.
- Stay current on vaccinations for diseases that weaken the lungs, such as the flu, COVID-19 and pneumonia.
- Stay physically active and exercise at least 150 minutes each week to keep your heart and lungs strong.
- Know your family history of heart disease and communicate this information to your doctor.
